Organization
ROBERTA J SMITH M D A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA M WENZEL (BILLER)
(310) 915-9154
Entity
Organization
Contact information
Practice address
970 MONUMENT ST STE 210, PACIFIC PALISADES, CA 90272-3891
(310) 459-4321
(310) 459-5436
Mailing address
970 MONUMENT ST STE 210, PACIFIC PALISADES, CA 90272-3891
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
G17205
CA
Other
Enumeration date
03/29/2010
Last updated
05/25/2010
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